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Objective:To analyze the diagnostic and prognostic value of routine bone marrow examination in patients with extranodal NK/T-cell lymphoma (ENKTCL) based on PET-CT staging.Methods:Clinical data of 186 patients who received bone marrow biopsy and bone marrow aspiration in Fujian Medical University Union Hospital from 2013 to 2021 were retrospectively analyzed. All patients were divided into bone marrow biopsy + bone marrow aspiration group ( n=186) and PET-CT + bone marrow biopsy group ( n=139). The sensitivity, specificity, positive and negative predictive values were compared between two groups. The data were analyzed and plotted. Survival analysis was performed using Kaplan-Meier method and log-rank test. Results:In the whole cohort, 45 patients were positive for bone marrow biopsy, and 30 of them were positive for bone marrow aspiration. A total of 141 patients who were negative for bone marrow biopsy also achieved negative results for bone marrow aspiration. A total of 139 patients completed PET-CT staging and bone marrow biopsy. And 30 patients were diagnosed with positive bone marrow by PET-CT, in which 22 of them were confirmed positive by bone marrow biopsy. Among 109 patients diagnosed with negative bone marrow by PET-CT, 5 of them were confirmed positive by bone marrow biopsy. All these cases were classified as stage Ⅳ due to distant metastases. PET-CT had a diagnostic sensitivity of 81.5%, a specificity of 92.9%, a positive predictive value of 73.3%, and a negative predictive value of 95.4%. Among early stage (Ⅰ-Ⅱ stage) patients diagnosed with PET-CT, all of them were negative for bone marrow biopsy (the negative predictive value was 100%). In stage Ⅳ patients ( n=55), the 1-year overall survival of patients with bone marrow involvement by bone marrow biopsy or PET-CT ( n=35) compared with their counterparts with the involvement of other organs ( n=20) was 28.7% vs.42.0% ( P=0.13), and 1-year progression free survival rates was 23.2% vs. 23.3% in ( P=0.94). Conclusions:Routine bone marrow biopsy does not change the original staging of patients with early stage ENKTCL based on PET-CT staging. Advanced stage patients with positive bone marrow biopsy tend to obtain worse prognosis, indicating that bone marrow biopsy still has certain value.
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Myosin light chain 9 (MYL9) is a regulatory light chain of myosin, which plays an important role in various biological processes including cell contraction, proliferation and invasion. MYL9 expresses abnormally in several malignancies including lung cancer, breast cancer, prostate cancer, malignant melanoma and others, which is closely related to the poor prognosis, but the clinical significance for its expression varies with different types of cancer tissues. Further elucidating the molecular mechanism of MYL9 in various types of malignant tumor metastasis is of great significance for cancer prevention and treatment. At the same time, as a molecular marker and potential target, MYL9 may have great clinical value in the early diagnosis, prognosis prediction, and targeted treatment of malignant tumors.
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Humans , Male , Biomarkers , Lung Neoplasms , Myosin Light Chains/metabolism , Prognosis , Prostatic NeoplasmsABSTRACT
Objective To investigate the clinical and biological features of patients with mixed﹣phenotype acute leukemia (MPAL). Methods The clinical data of 24 de novo adult patients with MPAL who were admitted to Fujian Medical University Union Hospital from January 2012 to October 2018 were retrospectively analyzed. These patients were diagnosed according to the World Health Organization (WHO) 2016 criteria. The clinical and biological characteristics of the patients were analyzed by morphological and cytochemical staining, immunophenotyping, cytogenetics and molecular biology. Results Of the 24 patients, 16 were male and 8 were female, and the median age of the patients at diagnosis was 27 years old (5-66 years old). The average blasts of bone marrow were (57.41 ±23.20)% . Thirteen cases (54.2% ) were diagnosed as MPAL morphologically, while 5 cases (20.8% ) were diagnosed as acute myeloid leukemia (AML), 5 cases (20.8%) were diagnosed as acute lymphoblastic leukemia (ALL) and 1 case (4.2%) was inconclusive. Eighteen patients (75.0%) co﹣expressed B﹣lymphoid and myeloid markers, while 5 patients (20.8%) with T﹣lymphoid and myeloid markers and 1 patient (4.2%) with B﹣lymphoid and T﹣lymphoid markers, respectively. The positive rate [median (range)] of CD38, HLA﹣DR and CD34 was 90.5% (0.1%-99.7%), 90.1% (1.1%-98.8% ) and 81.3% (0.1%-97.8%), respectively. Eighteen cases underwent chromosome examination, of which 5 cases carried with t(9;22)(q34;q11), 3 cases with t(v;11q23.3), 2 cases with complex karyotypes, and 2 cases with t(9;22)(q34;q11) and complex karyotypes, respectively. Twenty﹣one cases underwent genetic examination, of which 6 cases were positive for BCR﹣ABL, 3 cases were positive for MLL, 1 case was positive for MLL and BCR﹣ABL, 1 case was positive for BCR﹣ABL and TP53, and 1 case was positive for PHF6 and ASXL1 respectively. Of the 24 patients, 7 refused chemotherapy and 17 received induction chemotherapy. Of the patients receiving chemotherapy, 9 cases achieved complete remission (CR), 1 case was partial remission (PR), and 7 cases were not relieved (NR). In 11 patients treated by ALL﹣type induction regimen and 6 patients treated by ALL and AML﹣type induction regimen, 8 cases and 1 case achieved CR, the difference in CR rate was statistically significant (P<0.05). In 6 patients with Philadelphia chromosome (Ph) positive and 11 patients with Ph negative, 1 case and 8 cases achieved CR, the difference in CR rate was statistically significant (P<0.05). The median follow﹣up time was 5.5 months (0-36 months). The 3﹣year overall survival (OS) rate was 17.5% and the median OS time was 6 months. The 3﹣year OS rates in the allogeneic hematopoietic stem cell transplantation and non﹣transplanted groups were 75.2% and 0, respectively, and the median OS time was not reached and 4 months (P< 0.05). Conclusions MPAL is rare, it mostly co﹣expresses lymphoid and myeloid antigens and shows a much higher incidence of CD34, CD38 and HLA﹣DR. MPAL is often associated with Ph positive and complex karyotypes. MPAL has a low remission rate and poor prognosis, and a reasonable and effective treatment plan should be further explored.
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Objective To investigate the clinical characteristics and prognostic factors for patients with primary intestinal B-cell lymphoma. Methods The clinical data of 50 patients with primary intestinal B-cell lymphoma in Fujian Medical University Union Hospital from January 2004 to December 2013 were retrospectively analyzed. An analysis was also conducted in their clinical characteristics and related prognostic factors. Results A total of 50 patients included 35 males and 15 females with the median age of 58 years old (16-79 years old). The clinical symptoms were abdominal pain or abdominal distension [70 % (35/50)]. The common origins were small intestine and ileocecus, and the most common pathological type was diffuse large B-cell lymphoma (DLBCL) [54 % (27/50)]. The median survival time of 43 cases was 49.4 months. The 1-year, 3-year and 5-year overall survival (OS) rates were 79.1 %, 72.1 %, 58.1 %, respectively. Univariate analysis indicated that hemoglobin levels, albumin levels, lactic dehydrogenase (LDH), the maximum diameter of mass, international prognostic index (IPI) score, Lugano stage, and Eastern Cooperative Oncology Group (ECOG) score were the affecting factors of OS. Multivariate analysis showed that IPI score ≥ 2 was an independent risk factor for the prognosis of intestinal B-cell lymphoma ( OR＝ 6.766, 95 % CI 1.853-24.702, P＝ 0.004). The efficacy analysis showed that 5-year cumulative OS rate of R-CHOP like treatment group was better than that of CHOP like treatment group (91.7 % vs. 44.7 %, P ＝0.048). Conclusion IPI score can be used as an important indicator for clinical treatment and prognosis evaluation of primary intestinal B-cell lymphoma. Some patients with primary intestinal B-cell lymphoma can benefit from rituximab.
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Objective To investigate the efficacy and safety of intravenous itraconazole in different antifungal strategies for hematologic diseases patients with invasive fungal disease. Methods The efficacy and safety of intravenous itraconazole injection in the treatment of 160 hematologic diseases patients with invasive fungal disease, including the related factors were retrospectively analysed. Results The total efficacy rate of itraconazole was 58.12 %(93/160). The response rates in therapy for undefined patients without any evidence of patients, diagnostic-driven therapy for possible IFD patients, targeted therapy for proven IFD patients were 65.82 %(52/79), 53.57 %(30/56) and 44.00 %(11/25), respectively (P=0.054). The incidence rate of itraconazole-related adverse effect was 8.13 % (13/160), and the main adverse reaction was liver impairment. Multiple-factor analysis showed that the efficacy of itraconazole for the treatment of hematologic diseases patients with invasive fungal disease was not associated with age, medical history, agranulocytosis, and initial treatment. Conclusion Itraconazole itraconazole is effective and safe in the treatment of fungal therapy for patients with hematologic diseases.
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<p><b>OBJECTIVE</b>To observe the clinical characteristics of infections in adult acute leukemia （AL）patients during chemotherapy in hospital, and identify the risk factors for infections.</p><p><b>METHODS</b>A retrospective study of patients with AL who underwent chemotherapy between July 2010 and Dec 2014 in the First Affiliated Hospital of Xiamen University was conducted. Clinical features and risk factors for infections were analyzed.</p><p><b>RESULTS</b>191 patients with AL received a total of 728 courses of chemotherapies. During these admissions, 385（52.9%) infections episodes occurred. The common infections sites were lower respiratory tract infection（36.3%，153/374）, bloodstream infection（17.1%, 64/374）, oral infection（13.6%，51/374）, and perianal infection（13.4%, 50/374）. 164 strains of pathogenic bacteria were detected. Gram- negative bacteria were recorded in 59.1% of documented pathogens, and Gram- positive bacteria were responsible for 32.9% of infections. Multivariate unconditioned logistic analysis of factors identified consistent independent risk factors for no completely remission（OR=0.142, P< 0.001）, duration of neutropenia longer than 7 days（OR=12.764, P<0.001）, general wards（OR=1.821, P< 0.001）, and hospitalization interval longer than 10 days（OR=0.720, P=0.039）.</p><p><b>CONCLUSION</b>Infections after chemotherapy for AL continues to be common. AL patients with induction chemotherapy or severe neutropenia faced an increased risk of infections by multivariate analysis. And patients with short-term stay or laminar flow wards seem to be less susceptible to infections.</p>
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Humans , Acute Disease , Bacterial Infections , Gram-Negative Bacteria , Gram-Positive Bacteria , Hospitals , Leukemia , Drug Therapy , Microbiology , Multivariate Analysis , Neutropenia , Remission Induction , Retrospective Studies , Risk FactorsABSTRACT
Aim To investigate the effects of Zhiling capsule (ZLJN) on the proliferation inhibition and apoptosis induction in K562 cell line.Methods According to the different components of ZLJN,K562 cells were treated respectively with tradtional Chinese medicine,Western medicine and ZLJN compound groups.The cell viability and colony formation were observed by MTT assay and colony formation assay respectively.Apoptotic cells were detected by Annexin V-FITC/PI staining and DNA fragmentation assay.Caspase-3 activity was detected by flow cytometry,and pro-caspase-3 was detected by Western blot.Results Treated with drug,K562 cell growth and cell colony formation were significantly inhibited.Apoptosis occurring in the early stage was identified by Annexin V-FITC/PI staining.Typical DNA ladder was seen from gel electrophoresis and apparent apoptotic peaks were observed by flow cytometer.The level of caspase-3 activity increased after the treatment,while the level of pro-caspase-3 decreased.Conclusion ZLJN can efficiently inhibit proliferation and induce apoptosis in K562 cells,which may be related with the up-regulation of caspase-3 activity.
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Aim To explore the mechanisms of the apoptosis induction and the effects of adhesion suppression of Zhiling capsule (ZLJN) in small cell lung cancer cell line NCI-H446.Methods According to the different components of ZLJN,NCI-H446 cells were treated with traditional Chinese medicine,western medicine and ZLJN composite groups.Apoptotic cells were tested by light microscopy,Hochest33258 staining method.The mRNA and protein expressions of bcl-2,bax and hTERT were analyzed by RT-PCR and Western blot respectively.The expressions of CD44 were detected by flow cytometry.Results After NCI-H446 cells were treated with different drug groups,The morphological changes of apoptotic cells were found by light microscopy and Hochest33258 staining method.The mRNA and protein expressions of bcl-2 were down-regulated while the expressions of bax were up-regulated compared to the control groups(P
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Objective:To explore the expression and clinical significance of IRF-1 gene in leukemia.Methods:Revert polymerase chain reaction(RT-PCR) and gel image analysis system were used to analyse the expression of IRF-1 gene in 77 leukemias and 4 leukemic cell lines.Results:IRF-1 gene was found in 18 patients with acute leukemia.Significant low expression of IRF-1 gene was detected in the acute leukemia?chronic myelogenous leukemia(CML) and 3 leukemic cell lines HL 60 K 562 and U 937 compared with the normal and non-mallignant hematonosis (P